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Oral Flora? Meet the Microbiome in Your Mouth

What’s living in your mouth?

Human beings live with microorganisms. In fact, scientists now tell us that we live in a symbiotic relationship with mostly bacteria, but there are also viruses, fungi, and protozoa (for example, the amoeba that you learned about in school). Scientists believe your specific cadre of bacteria and other organisms is unique to you and stays stable over time. Nobel Prize winner, Joshua Lederberg named this interconnected community of microorganisms the microbiome. When microbiomes are stable and have the right variety of microorganisms, we are much more likely to be in good health.


In humans, the microbiome exists in several areas, but mostly in the mouth and the small and large intestines (gut). Bacteria in the mouth is called oral flora and, with the microorganisms in the nasal cavities, make up the mouth microbiome. The mouth itself has several separate areas where oral microorganisms live. These are teeth, gingiva (gums), the gingival sulcus (the space between your teeth and gums), cheeks, tongue, lip, hard and soft palate. One study using DNA testing in nine different parts of people’s mouths found an average of 296 different species of microorganisms!


What does the microbiome do?

The good - Symbiosis:

Microorganisms don’t just live next to each other. They organize themselves into communities called biofilm that attach to surfaces in their particular area of the body. Examples of what a properly functioning human microbiome does include helping to protect the immune system, digest food, detoxify chemicals we take in from the environment, and protect us from microorganisms that cause disease. The fact that there are hundreds of different species in the biofilm on your teeth (as in other areas with microbiome) is actually a sign of a healthier mouth. The interaction between the mouth microbiome and the body tends to maintain stability. This helps keep the tissues of the mouth from becoming infected despite the large number of bacteria, and helps protect against bacteria that do not ordinarily live in the mouth. Saliva also helps keep the mouth healthy because it contains enzymes and other substances that keep the mouth microbiome in balance.

The bad: Dysbiosis:

Microbiomes become dysbiotic when the usually stable balance of diverse microorganisms is changed. Scientists think this may happen because the healthy environment in the mouth changes in a way that allows one or just a few microbe species to take over. Or disease-causing bacteria, which may not cause problems in small numbers, are able to increase their population. Sometimes the mouth environment is altered because of hormonal changes (such as in pregnancy or puberty) or increasing age. Other major reasons are poor oral hygiene, bad dietary choices, and smoking. Large masses of bad bacteria can develop on teeth and become plaque biofilm that may produce more acid. Over time, bacteria are produced that become more tolerant of the new, more acidic environment. These changes can lead to inflammation causing gingivitis and periodontitis as well as dental caries.

The ugly:

The results of periodontal disease may not always stay in the mouth. Inflammation caused by disease-causing bacteria in the mouth makes it easier for the bacteria or toxins from it to leak into the blood stream and spread to other areas of the body and cause more inflammation. Some research studies suggest that periodontitis may be linked to diseases like Alzheimer, Parkinson, and cardiovascular disease among other conditions.


Your mouth and your gut

Researches also believe that the mouth microbiome may exchange bacteria with the microbiome in the rest of the gastrointestinal tract. Diabetes is associated with periodontal disease, and some studies suggest that it is associated with changes in the microbiome of the gut. This may cause a change in the oral microbiome that can cause inflammation, bone loss and periodontitis. Rheumatoid arthritis, also an inflammatory disease, has also been associated with periodontal disease. One study from China showed dysbiosis in the oral and gut microbiomes of patients with rheumatoid arthritis, and similar bacterial changes were seen in both areas.


How to keep your mouth healthy

Keeping your mouth as healthy as possible is important not just for a healthy smile, but to help maintain your health in general. An unhealthy plaque forming biofilm will cause a vicious cycle of increasing bacteria, inflammation, which breaks down tissue, providing more nutrients for the growth of more bad bacteria, until the process is stopped. The goal is to maintain or restore a healthy microbiome or oral flora

- Practice good oral hygiene. Brush twice daily and floss at least daily. Avoid or limit sugary sweets and drinks, and even less sweet starchy foods, and brush or rinse after eating or drinking.

-Maintain a healthy diet, and if you are a diabetic, follow your doctor and nutritionist’s advice on keeping your blood sugars under control.

- If you smoke, quit as soon as you can, since smoking is one of the factors that can change a healthy oral microbiome and lead to dental disease.

- Visit your dentist regularly for cleaning and care of your teeth.


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